Project Firstline: Creating a Culture of Shared Responsibility
‘It’s not just the epidemiologist or infection preventionist’
About three years into an experiment to teach infection control basics to healthcare workers in short snippets directly online, the Centers for Disease Control and Prevention (CDC) is doubling down on Project Firstline as key preparation for the next pandemic.
Michael Bell, MD, of the CDC’s division of healthcare quality promotion, underscored the importance of Project Firstline in a talk on pandemic preparedness at the recent conference of the Society for Healthcare Epidemiology of America (SHEA).
“We’re investing a lot in this right now,” he said. “The reality here is that a lot of the recommendations that we make are to our colleagues who are trying to define a policy for a healthcare facility, but that doesn’t always reach to the front lines that are supposed to implement them.”
Another SHEA 2023 speaker, CDC Project Firstline lead Liz McClune, MSQ, MPA, said the pandemic highlighted longstanding gaps in infection control knowledge and practice in healthcare settings.
These gaps reflect disparities in infection control expertise, structural gaps in infection control training and education, and a lack of understanding of effective educational approaches for healthcare workers. Framing infection control as rules, policies, and procedures, has not been effective, she said.
Research with healthcare workers has found that formal infection control training is considered generic, infrequent, unengaging, and sometimes outdated, she said.
“Unfortunately, we framed IPC (infection prevention and control) as just rules, policies, and procedures — something you write down in a binder and keep on the shelf,” she said. “But we know that it’s not. It’s action; it’s complex. People who are engaging in IPC aren’t hall monitors. But when you frame infection control as ‘don’t do this because of CMS (Centers for Medicare and Medicaid Services) and don’t do that because of OSHA (Occupational Health and Safety Administration),’ then [that is the perception].”
Some infection preventionists may take exception to this description of cursory education and monitoring, but most usually say they welcome all the help they can get. Indeed, Project Firstline is trying to contribute to a work culture of shared responsibility. “It’s not just the medical epidemiologist or the infection preventionist, it’s every nurse, every respiratory therapist, every environmental services worker,” said McClune. “All for a goal that I think all of us buy into, which is we want to keep people from getting infected.”
As this report was filed, the Project Firstline website had a wealth of short videos, infographics, social media memes, and other ways to reach healthcare workers on multiple platforms.
Some of the materials prompt the curious with a title such as, “What is a virus?” As infection preventionists are well aware, the answer could be complicated, since there is longstanding discussion on whether viruses are living things, even after they penetrate a cell to replicate. The Project Firstline answer opens with this explanation: “Viruses are a type of germ that can infect a host body and cause illness, like a cold or COVID-19. A virus uses living things, like animals and people, to make copies of themselves. Then they keep spreading from one living thing to another.”
The content is tailored to a narrow bandwidth, with the idea that healthcare workers with little time can learn from little packets of content that are tailored for integration into their workday practice.
“No one wants to go on their ride home on the bus, finally get home and put their kids to bed, and then say, ‘I’m going to go Google infection control and learn a little something more,” McClune said. “No one’s doing that, and that’s OK. They should be able to have work-life balance. We need to know where they’re already at and find them. We want to do the work and not ask our healthcare workers to do more than they’re already being asked to do. And then we want to understand what are those products, what are those messages that can really hit home and reinforce the information that you all know innately.”
Editor’s note: To access infection control materials and information on the CDC’s Project Firstline website, go to: https://www.cdc.gov/infectioncontrol/projectfirstline/index.html
About three years into an experiment to teach infection control basics to healthcare workers in short snippets directly online, the Centers for Disease Control and Prevention is doubling down on Project Firstline as key preparation for the next pandemic.
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